Precision Immunogenetics and Histocompatibility: Transforming Kidney Transplant Outcomes

Kidney transplantation remains the treatment of choice for end-stage renal disease; however, long-term graft survival continues to be limited by alloimmune injury. Over the past two decades, major advances in immunogenetics (including high-resolution HLA typing, highly sensitive antibody detection platforms, molecular mismatch analysis, and improved crossmatching methodologies) have significantly enhanced immunologic risk assessment in transplantation.Despite these technological advances, a critical gap persists between laboratory innovation and clinical implementation. Although immunogenetic testing has become increasingly sophisticated, translating these insights into improved patient outcomes, optimized donor selection, personalized immunosuppression, and durable graft survival remains an ongoing challenge.This Research Topic aims to provide a comprehensive and translational perspective on how modern immunogenetic tools inform clinical decision-making in kidney transplantation. By integrating laboratory science, clinical research, and implementation strategies, this issue seeks to define the current state of precision immunogenetics while identifying future directions to improve transplant outcomes.This Research Topic focuses on the clinical application and translation of immunogenetic research in kidney transplantation, with particular emphasis on addressing practical gaps and emerging opportunities. We welcome submissions addressing, but not limited to, the following areas:• From CDC to Virtual Crossmatch: The Evolution of Compatibility Testing in Kidney Transplantation• Precision HLA Genotyping and Molecular Mismatch Assessment: Advancing Risk Stratification and Personalized Immunosuppression• Donor-Specific Antibodies: Immune Risk Assessment, Monitoring, and Outcome Prediction• Beyond HLA: Non-HLA Antibodies and Genetic Determinants of Transplant Outcomes• Innate Immunity and Immunogenetic Interactions in Kidney Transplantation• ABO Compatibility and Strategies for ABO-Incompatible Kidney Transplantation• Donor-Derived Cell-Free DNA as an Emerging Biomarker of Antibody-Mediated Rejection• Precision Desensitization: Targeted Immune Modulation for Highly Sensitized Candidates• Achieving Clinical Transplant Tolerance: Mechanisms, Strategies, and Barriers• Cost-Effective Histocompatibility Approaches in Resource-Limited Settings Topic editors: Raja Rajalingam, Narinder K Mehra Source: https://www.frontiersin.org/research-topics/78218/precision-immunogenetics-and-histocompatibility-transforming-kidney-transplant-outcomes